Stanky

Sitting in Starbucks this afternoon, salivating over inspiring pictures on wedding and fashion blogs, my daydream of bow-ties and peonies was interrupted when Dr. D (who is a hostage of Step 1 Boards cramming--but more on that later) leaned over with his pathology textbook and pointed at a diagram.

Here comes another lesson in med cred, I thought, preparing myself for something either very bizarre or very gross. It was the latter:

Today I learned that when a person has cirrhosis (or severe scarring) of the liver, one of the signs is fetor hepaticus. What might that be, you ask? Well, according to the textbook's description, fetor hepaticus--which already doesn't sound too good--is a particular odor on the patient's breath. Oh, but not just any odor...

"The smell of a freshly opened corpse."

Aw, HECK NO.

First of all, bummer for whoever already knows what that smells like and is consequently capable of identifying that smell on someone's breath. Second of all, why are we talking about corpses like they're a can of caviar? Freshly opened, seriously? Third of all, what unfortunate soul has been dealt the extremely ill-fated hand of being the person who decides how to categorize the odors of sick people's breaths? "Ah yes, in this one I get notes of sweetness, perhaps honey-like... this one has more of an acidic hint... and thi---OH EM GEE YOUR BREATH SMELLS LIKE DEATH. THE FRESHLY DECAPITATED KIND."

I think I'll be less self-conscious about garlic breath from now on... at least now I know it can always be worse.

Sweet, sedentary Saturday

Just a quick post to say that I spent my Saturday being a laaaaaazy sack of good-fer-nothin'. And man, did it feel good.

Our home currently contains new batches of cookies and biscotti (this time white chocolate macadamia--yum!), as well as an additional four-legged friend whom we are looking after while his humans are on their honeymoon. Let me tell ya, it's hard to be productive when you're surrounded by sleepy dogs and an endless supply of baked goods. It is a miracle that I found enough motivation to drag my bummin' behind to the gym this afternoon. A marvel, I tell you.

I'm currently drafting about three different blog entries, but none are finished, so for the interim day or so I thought I might post another recipe. This one is in my regular cookie-rotation, and one of Dr. D's faves. I typically make a vegan alternative so we can share with friends (just substitute butter with margarine and eggs with unsweetened apple sauce), but these consistently come out well, vegan or otherwise.

Peanut Butter Chocolate Chip Oatmeal Cookies

3/4 cup butter
1/2 cup white sugar
1 cup brown sugar
2 eggs
1 3/4 cup flour
1/2 tsp. baking soda
3/4 cup peanut butter (chunky preferable)
1/4 cup water
1 tsp. vanilla extract
2 cups quick-cooking oats
1 cup chocolate chips

Preheat oven to 350 degrees. In large bowl, cream together butter, brown sugar, and white sugar until smooth. Beat in eggs one at a time, then stir in peanut butter, water, and vanilla. In separate bowl, combine flour, baking soda, and salt; stir into creamed mixture until blended. Mix in oats and chocolate chips. Drop by spoonfuls onto ungreased baking sheets. Bake for 14-16 minutes. Yields approximately 42 cookies.


But maybe before you try your hand at this recipe, you should come take some of this mountain o' baked goods off our hands. Please...?

Father's Day & An Ode to Nurses

Everything was going according to plan. Dropped J-dog off with the dog sitters (who planned to use him as chick-bait all weekend), got to the airport with that typically-elusive "time to spare", flew non-stop across the country with no delays, spent a couple wonderful evenings with good friends, attended a beautiful wedding... and then got the phone call on Saturday afternoon.

Let's just say the subject of the call was medical in nature, and the news was not good. It was the kind of news that punches you in the stomach. And it involved a man who we planned to celebrate the next day, on Father's Day. He had fallen very quickly, seriously, and unexpectedly ill. We immediately changed our plans, said rushed goodbyes to our friends, and sped off in the rental car to our hometown where he was in the hospital.

But this post isn't about him, our dear patient (I'll call him ODP in the continued spirit of pseudonyms), because it's a personal matter that affects more than just myself and Dr. D and I'd like to respect the privacy of the other family members involved. Suffice it to say that ODP was very, very ill and had to spend many days in the hospital. No, this post is not to go into the complicated medical details, the emotional roller-coaster, the play-by-play of treatment. This post is to record observations from my first trip to a hospital in over a decade, and to express my awe for the nursing staff.

First, some hospital observations:

• Step-Down Units are both a blessing and a curse. On the one hand, it's best to avoid being admitted into this unit because it means you're in some pretty serious medical distress. But on the other hand, you've got roughly 5 million medical personnel looking after you (slight exaggeration, but still), AND a private room. Also, your visitors benefit from a private bathroom, reclining chairs, and complimentary coffee. It's basically the Four Seasons of misery.
• There is no other setting (or at least I've yet to find one) as capable of making those of us who are not medically-inclined feel more useless and "durr"-worthy as a hospital. I mostly just sat there, wringing my hands and trying to think of witty/cheery things to say. My two moments of shining glory: quickly grabbing the larger of two pinkish-mauve container thingies (why is everything in the hospital that color?) when we thought ODP might puke, and suggesting that we ask the nurse for a popsicle when ODP was lamenting that he had a craving for a snow cone. Which brings me to my next point of observation...
• Those of us in the know (and you are now one of them) can get popsicles in the hospital at any time upon request. This particular hospital must have caught on to the fact that the best, most worthy flavor for sick people is cherry, because that's all they had. I'd like to shake the hand of whoever made that decision. Good call.
• Whoever plans hospital meals must hate sick people. That turkey with apple compote topping was lurking maliciously on its tray in the corner, just waiting to finish off any patient delirious enough to think it might actually taste good. And the popsicle flavor-decider person seriously needs to assert power over the choice of Jello flavors, because green? Really?
  
• Being on the same floor where inmates are treated (which was crawling with uniformed officers) has a way of making you feel simultaneously safe and nervous. One wrong turn down a hallway, and you're in Shawshank Redemption.
  
• I don't make it a habit of making excuses for people who wear Crocs because they are hideous, but nurses have my Croc-wearing blessing because they never stop moving. Great googly moogly, those are some hard-working folks. Not to mention all of the bodily fluids/accidental privates-flashing/thanklessness they encounter throughout the day. If I ever wore hats, they would be all off to you, nurses. They made this whole ordeal bearable, and they even took the time to answer some of the more intricate questions that Dr. D had for them. I was so impressed with their service (and I also had some time on my hands in the hospital) that I would like to honor them in one of the best ways I know how: in haiku form. Here it goes...
  

You stay behind to
translate doctor-gibberish.
We are so grateful.
...
How can you nurses
all talk about poop straight-faced?
I'm so immature.
...
Starting your shift with
stressed, un-showered visitors
has to suck. Sorry.
...
I don't understand.
So chipper at 2am.
Are you on drugs, too?

At any rate, ODP has been discharged and we will all sleep a little better tonight. A belated Father's Day gift, indeed.

Anniversary of the "r"

Exactly two years ago, I stood in front of the bathroom mirror in a swank hotel suite, leaned forward, and looked for it: some sort of sign, or maybe a tag or bar-code revealing the newest part of my identity that had been created by the events of the day before.

Wife.

I turned my head a couple times, scrunched my nose and forehead, made a few more faces. No sign of it. I found no visible mark giving away the fact that I was now the proud owner of a new and shiny title, that I had finally achieved a relationship status worthy of cramming that "r" in between the two letters of "Ms." But wow, did I feel different. I was giddy and at peace all at once. It was like I had just received a lifetime guarantee on... well, life.

And as far as I've been able to tell over the past two years, that guarantee was basically that life will be awesome. Yes, awesome really is the best word for it. I thought about saying "perfect," but that's not really true. Things still can (and do) go wrong, but we're able to get through and grow from the struggles, and are usually filled with awe when we see how everything comes together in the end. Life is awesome. And my husband is an awesome gift...

Homeboy makes me laugh like no other. He's the perfect extroverted balance to my touch-and-go introversion. He makes a mean crock-pot of beans, and he trained himself to like olives and pickles because I love them on the Subway sandwiches we split. He's spent the past twelve years or so learning to interpret my nonverbal language, so now when I'm too upset or annoyed or sad to put things into the proper words, he can do it for me. He makes flying on planes less scary. He understands my need for chocolate and the occasional rap music binge when scanning through radio stations, and he judges neither. He is a man of science and faith, and he's learning to heal people. I love him for these reasons and for countless others.

Happy anniversary, Dr. D. Thanks for the "r."

Biscotti Hottie

My mother is a phenomenal cook (I bet she's humbly scoffing as she reads that statement, but don't let her fool you). I was one of those kids that led a rather charmed, Leave It to Beaver-esque existence when it came to the home she made for us all. Home-cooked meals, cookies made from scratch, beautifully decorated dining tables... basically she's a kind of Martha Stewart/Julia Child hybrid, but even more awesome, if you can imagine. Although seemingly scattered at times, and always modest, she manages to perfectly orchestrate meals--whether they are for four or fourteen--down to the last, votive-lit detail. This is a photo of a dessert table that she just "whipped up" for an open house we had over Christmas. No big deal, right?

I truly wish I could say that I take after my mom in the culinary department, but in reality, cooking stresses me the heck out. First of all, give me something hot to handle and I will burn myself, it's just a question of how badly--on a scale of 1 to instantaneously bubbling, how bad is it? Second, if I have to time the completion of multiple dishes at once, I go manic. I start yelling at vegetables and forget to wear oven mitts (again, going back to the burning thing... not pleasant). Picture the frenzied pace of Iron Chef but instead of having a legitimate reason to be frantic, like on-the-fly desserts made with truffled buffalo pâté, I'm just trying my darndest to pan-fry a chicken breast.

The one exception to my kitchen conundrum is this: I somehow manage to fair better when it comes to baking. Before you try to tell me that baking is cooking, let me stop you: BAKING IS NOT THE SAME THING AS COOKING A MEAL. I cannot be convinced otherwise. Many have tried, all unsuccessfully.

When I bake, I can focus on one thing at a time. Oven on. Mix the dry ingredients. Mix the wet ingredients. Combine. Stir until your arm falls off. Bake. Cool. Munch. There's no guess-work in baking; no "for heaven's sake, does this need more salt? DOES IT?!"; no having to keep things warm while you're waiting for the other stuff to hurry-the-heck-up and cook already; no working with raw meat--yucka! Yes, Dr. D is a much better cook than I, so best to stick with what I'm good at.

Last weekend, in a fit of ambition (and after witnessing my husband glance listlessly into his morning coffee and mumble a wish for something sweet to go with it), I decided to try my hand at biscotti. I didn't think it would be possible to make Dr. D love me any more than he already does, but I may have achieved just that with this simple recipe. I even earned a new nickname; Dr. D, with a mouth-full of warm almond cappuccino chocolate chunk biscotti, dubbed me his "biscotti hottie."

Just in case anyone wanted to give it a go, I'm including the recipe below. A word of warning, however: the recipe calls for parchment paper to bake the loaves on. If you're a baking newb like me, you're probably like "huh?" Yeah, I had no idea what it was either. Dr. D was so excited about the prospect of fresh biscotti that he made a special trip to the grocery store for me to track down this elusive baking item, and after no success finding it on the shelves, he managed to charm one of the workers in their bakery into lending us some (and when I say "some" I mean 1 sheet--this stuff must be hard to come by!). I plan to go to a larger store in the near future and see if I can stock up, because this is only the biscotti beginning for us :)

Toasted Almond Cappuccino Biscotti with Chocolate Chunks

3/4 cup sliced almonds, toasted
1/2 cup semisweet chocolate chunks
2 cups flour
1 cup granulated white sugar
1/2 tsp. baking soda
1/2 tsp. baking powder
1/2 tsp. cinnamon
1/2 tsp. salt
1/4 tsp. cloves
1/4 cup espresso or strong coffee, cooled
1 tablespoon milk
2 eggs
1 tsp. pure vanilla extract


In a small bowl, whisk together the espresso (or coffee), milk, eggs, and vanilla. In a large bowl using a hand mixer, beat the flour, sugar, baking soda, baking powder, salt, & spices until combined. Gradually add wet mixture and beat until dough forms, adding morsels about halfway through. With floured hands divide the dough in half. On a lightly floured surface roll each half into a log about 10 inches long and 2 inches wide, and transfer to parchment paper lined baking sheet, spacing 3 inches apart. Pat down slightly. Bake for 35 minutes at 350 degrees, then let cool for 10 minutes. Reduce heat to 300 degrees, slice the loaves on a diagonal (about 3/4 inch wide slices) and bake slices for 5 minutes on each side or until pale golden. Serves approximately 30 slices.

MM 101, Lesson 2: Battle of the Snooze

"What time did you set your alarm for?"

So begins our routine nightly conversation, post-pillow adjustment and pre-lights out. It has the pretense of being a very delicate operation: the answer to this question stands to dictate not only who gets first dibs on the bathroom, but what time breakfast will be (or if there's any at all) and who will take J-dog out for his morning business.

Notice I say pretense and stands to. The morning alarm could very well determine the course of the entire day, and there was a time in my life (when I didn't live with Dr. D) when that was most certainly the case.

But that was before the Epic Battle of the Snooze slithered its silly little way into my mornings. Yes, friends, my husband has a snoozing problem. "Problem" may be too mild of a word. Dependency. That's more like it.

And here's my next lesson in medical matrimony: you cannot win this battle against a med student.

Oh, how I've tried. When the snoozing began during the first week of Dr. D's first year, I dismissed it as a fluke, rationalizing to myself that he wasn't used to getting up before 7am and he'd adjust eventually. As the snooze attacks continued, however, I realized I had to take some sort of action. Return fire. I discovered that there would rarely be a time when my alarm was set to go off before his, so measures had to be taken or I would be forced to repeatedly listen to the "Awoooga! Awoooga!" of his alarm at 9-minute intervals, which is just long enough to doze back to sleep, mere seconds before being ungraciously jolted back into consciousness. Multiple. Times. My responses evolved over time:

• Hoping that Dr. D might not realize that I, an innocent civilian, was caught in the cross-hairs between his need for "five more minutes, Mom" and the unforgiving punctuality of his alarm, I started to make passive comments about the morning struggle. I tried things like, "Boy, rough getting out of bed this morning, eh?" and "You must have been knocked out! Didn't hear the first couple of alarms, huh?" This tactic failed miserably.
• Next, I tried the stir and pat method. This involved intentionally stirring when his alarm went off (to signal that the alarm had worked on me, so maybe it should work on you too?) and then rolling over and patting him on the shoulder in an okay-time-to-get-up-please manner, which, if you're wondering, consists of two pats and a small counter-clockwise rub (repeat as necessary). This was met with limited and sporadic success.
• Alright. Hardball time. ...otherwise known as the "grumpy wife" maneuver. This one typically only came into play if I realized that he'd snoozed all the way from his original alarm time to a few minutes before mine was set to go off, eliminating any chance I had of getting back to sleep before my alarm. It's too ugly to go into much detail, but suffice it to say there was a lot of violent blanket yanking, angry rolling over, audible sighs of frustration, and even a stray kick or two aimed in Dr. D's general vicinity. Only ineffective on really snoozy mornings, but never a pleasant way to start the day.
• Finally, I played the pity card; something to the effect of me whining, "I can't handle the snoooooooze! It's not faaaaaaiiiiiiir!" And to my dear Dr. D's credit, he awarded me with a period of detente.

Ah, but old habits die hard. I will say it again: you cannot win the battle of the snooze against a med student. The snooze stealthily crept its way back into my life and eventually (please brace yourself)... I was taken prisoner. That's right, I am now a prisoner of war in the Epic Battle of the Snooze. I've even assimilated into the snooze culture.

I am a snoozer. I am an epic snoozer of med school proportions.

Sigh.

The Pressure/Puppy Paradox

Getting a dog of my own was always something I threatened to do. It began the week after I left home and settled into the residence halls for undergrad. I remember telling my boyfriend (aka Dr. D) that I'd found a loophole in the university's pet policy, which only allowed pets that were fully submerged in water: "I'll just, you know... throw the dog in a bucket of water whenever the RA comes by." As you can see, my threats to get a dog were always fairly empty. My puppy lust usually correlated with my stress level, so I would typically go through a couple days of intense longing for puppy breath on my face, and then when my exam was over or my paper was finished, I could get back to living my normal, dog obsession-less life.

Fast forward five years. Past graduation, past the proposal, past Dr. D getting notified that he was accepted to med school, past the wedding aaaaaand... about half-way through our cross country move. Just Dr. D and me, together in our gas-guzzling (but oh-so-free) mom-mobile for three days straight with nothing to do but eat MSG-licious gas station snacks, listen to Order of the Phoenix on audiobook, and, oh yeah, talk about this thing we got ourselves in to called marriage.

At some point over those three days of conversation--which ranged from "what the heck is 85 octane?" to "yeah, 'Thor' is pretty awesome, but what about girl baby names?"--I felt compelled to casually bring up the possibility of getting a dog.

"Okay, so no kids for a while. How about a dog?"

"Yeah!"

Upon first reading, I know that looks like an emphatic heck-yes-let's-get-a-dog-right-NOW! kind of response from Dr. D. But here's what doesn't translate to writing: another thing I've learned that Dr. D does (which he will deny to the grave, I imagine) is when he doesn't really want to do something or agree with something but he also doesn't want the other person to know that he doesn't, his voice gets really high-pitched. Just shy of shrill, really. So read the above exchange again, keeping that in mind.

Hmm.

I don't remember exactly where the conversation turned from there, but I do remember mentally filing the dog issue into my "keep talking about it occasionally to warm him up to the idea" category (also in this category: buying shoes that aren't from Aldo, the tv show Weeds, Lilith Fair, and cheese).

But then something odd happened. We got settled in to our new place, I started my job, Dr. D started classes, and then he started hounding (hah!) me about getting a dog. Apparently without making the conscious effort to do so, I had started talking so much about dog ownership and being on the fence about it that Dr. D practically had to wrestle me over the edge. I was so stressed about being in a new place in a new job with a new husband who had all this new pressure that my puppy lust came back in full force and I didn't even realize it! All the stress was making me crave a dog, but I was too stressed to fathom actually getting one. Thank goodness for my husband...

"Seriously! Let's just get a dog. I mean it." Normal pitch and everything, ladies and gents. That's love.

And so, we ended up with the ferociously fluffy, always awkward J-dog. But that's a story and a lesson for another time.

J-dog turned 2 today :]

Drink it up

This is going to be a short one today, not because I don't have a lot to say (as I carefully eye the mounting list of blog topics I've been amassing), but because I think that this topic deserves a glaring spotlight to highlight how astounding it truly is. Excess words would diminish its impact, so I'm just going to jump right in to what I learned last night...

Huddled around a small table at one of our favorite malty, hoppy beverage establishments with a group of friends from med school and its program-cousins (MD/PhD and Vet Med), this gem of knowledge regarding the miracle of life was shared with me:

In order to develop a healthy set of lungs, among other vital organs, fetuses must drink a sufficient amount of amniotic fluid. Okay, whatever... even pre-babies have to get their drink on somehow, I guess, I mean they probably get pretty thirsty because it's got to be really warm in--WAIT, amniotic fluid is FETUS PEE?!


...and here you were thinking that the first time in your life you'd be faced with drinking your own urine would be when you got stranded on some desert island. No such luck.

I'm now weirdly comforted by the fact that I have a lower-than-normal lung capacity. Even in the womb, I must have realized that what I was doing was gross.

How do you know?

You know you're married to and/or living with a medical student if...

• You feel the need to let your doctor know that your spouse is in med school—like it's going to earn you a gold star or better service or something—and then you use medically preferred terms (like "urinate" instead of "pee") to prove it.

• Eating dinner next to a textbook with a graphic picture of a skin disease (pemphigus vulgaris, anyone?) not only doesn't bother you, it's a jumping off point for the meal's conversation.

• You don't find out until about half-way through the semester that your husband wears the same pair of scrubs every day in the anatomy dissection lab, and oh by the way, can you wash them?

• You know who "Poppie" Goljan is and have heard most of his life story second-hand from your husband in the glowing, admiration-filled praise he normally reserves for rock stars and super-heroes.

• You find yourself making songs out of catchy medical terms because they’re fun to say (i.e. ankylosing spondylitis: “ANG-key-LOHS-ing SPAWN-dee-LIE-tis!”), but you have no idea what they mean.

• There is no longer any mystery at all surrounding the female physical exam because your husband, who was worried that you would freak out because he was forced to practice it on volunteer patients, described every move to you in detail so it wouldn't seem like infidelity. Those poor, poor volunteers…

• Purchases are rationalized with: “Well, we’re thousands of dollars in debt anyway, so in the scheme of things…”

• Your Palahniuk collection on the bookshelf is slowly being overtaken by far more disturbing literary works: Step 1 Boards prep materials and illustrated pathology textbooks.

• You stop biting your fingernails because WOAH. Do you have any idea what kind of stuff can live under there?!

• The Latin names for medical terms and the spells from Harry Potter all start to sound the same, so eventually you both end up waving a pretend wand in the air and exclaiming names of fungi without really thinking about it. "Aspergillus fumigatus!" ...oh, is that just us?